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care or mental health care professional stating the incapacitated parent is not capable of caring for the children in the family.

When a parent of a participating or renewing family becomes incapacitated they are considered to be in an eligible activity.

When a renewing family reports a parent becoming incapacitated between the date their application was submitted to the Designee and the date of eligibility determination, eligibility is based on incapacitation. A parent is considered incapacitated when he or she is incapable of caring for children in the family by reason of hospitalization, or being physically or mentally unable to care for a child, as determined by a health care or mental health care professional.

Parent(s) who are in an in-patient rehabilitation or treatment setting are considered to be hospitalized for purposes of determining if they are incapacitated. The parent is considered to be in an eligible activity. If the parent is receiving rehabilitation, or treatment services as an out-patient, they are considered in an eligible activity during the times they are participating in the required rehabilitation or treatment activities.

A parent who is incapacitated must provide a completed Health Status Report CC24, or similar documentation stating the parent is not capable of caring for the children in the family, completed by the health care or mental health care professional. The determination must include the length of time the incapacity is estimated to last and any diagnosis or condition to determine if this is a temporary meaning there will be an end date for the incapacity and a date to return back to work or permanent incapacity. Designees and CCPO are to protect all information provided on the Health Status Report CC24 from furtherdisclosure under the Health Information Portability Accountability Act (HIPAA).

The Health Status Report CC24 is considered valid from the date the first verification is signed by the health care or mental health care professional regarding the incapacity through the last day of the month in which the health care or mental health care professional has noted on the Health Status Report CC24, or other documentation that has been provided by the family, to determine the timeframe of the incapacity.

When incapacity has been reported without verification, a Child